Supporters of mandating paid sick leave for Portland workers have the ear of Portland Commissioner Amanda Fritz. "It's a huge public health issue that many workers in Portland don't have even one day of paid sick time," Fritz said.Michael Lloyd/The Oregonian

A child develops a fever at school. Teachers worry that his illness is contagious. But the student can't go home early because his parents are stuck at work, unable to take a sick day to care for him. Statewide, school nurses can't give medication to students, not even Tylenol, without written parental permission, Occhi said.

So the child sits and waits, fever raging.

Paid sick leave

San Francisco: In effect since Feb. 2, 2007. Voters passed the nation's first such ordinance, giving employees the ability to earn and maintain a rolling bank of up to 72 paid hours to tend illness, injury or medical care, or to care for a family member or "designated person."

Washington, D.C.: In effect since Nov. 13, 2008. The District of Columbia Council passed the law to grant employees up to seven days a year to tend illness, injury or medical care; to care for a family member, including a domestic partner; or to handle issues related to domestic violence, sexual abuse or stalking of the employee or a family member.

Connecticut: In effect since Jan. 1, 2012. Covers employers of 50 or more and grants service workers up to 40 hours a year to tend illness, injury or medical care; to care for a spouse or child; or to handle issues related to domestic violence or sexual assault of the employee.

Seattle: In effect since Sept. 1, 2012. The City Council approved three tiers of rules for employers of five or more, granting employees up to 72 hours a year to tend illness, injury or medical care; to care for a family member; to handle issues related to domestic violence, sexual assault or stalking of the employee or family member; or because the workplace or child's school or care center was ordered closed because of an infectious agent, toxin or hazardous material.

"That's a difficult spot for a parent to be in," said Occhi, a registered nurse who works in the David Douglas School District. "It's difficult all the way around."

But a coalition of activists would like that to change in Oregon, starting in Portland. Led by the advocacy group Family Forward Oregon, the Everybody Benefits coalition wants the Portland City Council to adopt a citywide rule that would require all employers -- big and small, public and private -- to offer some form of paid sick leave.

"It's a huge public health issue that many workers in Portland don't have even one day of paid sick time," Fritz said. "It's clearly a concern when people are coming to work sick. It's also a problem when parents have to send their sick children to school because they can't afford to be off work."

The activists have several models to follow. The city of San Francisco became the first government in the United States to enact a paid-sick-leave ordinance, in 2007. Officials in Washington, D.C., followed suit in 2008.

In Seattle, paid-sick-leave rules took effect in September. Connecticut became the first state to mandate a rule in January. The laws vary across jurisdictions, with some exempting businesses with fewer than 50 employees, for example.

Other cities are gearing up for campaigns. But elsewhere in the country, efforts have failed to gain traction or have run into trouble. Denver voters overwhelmingly rejected a November 2011 ballot measure, persuaded by business groups' pleas that the measure would hurt small businesses. In Wisconsin, Gov. Scott Walker blocked a voter-approved Milwaukee ordinance.

No specific proposal has emerged in Portland, and Fritz said she doesn't want to rush one.

It's also unclear whether she would have the votes to pass a rule before the end of the year, as some activists have urged. Commissioner Randy Leonard, who leaves office at the end of December, supports the push. But Commissioner Dan Saltzman has said he would prefer a statewide effort. Mayor Sam Adams, who also leaves office at year's end, and Commissioner Nick Fish declined to comment.

Business groups, meanwhile, are in wait-and-see mode. Megan Doern, a spokeswoman for the Portland Business Alliance, said small-business owners are calling with concerns because no details have been discussed publicly.

Joe Gilliam, president of the Northwest Grocery Association, said his group is optimistic that Portland could achieve something "workable." But he said he worries that Portland might go the way of Seattle, which has three sets of rules for small, medium and large employers.

"The Seattle one is an absolute regulatory nightmare," Gilliam said. "We're very concerned it would look like Seattle's."

Julie Nelson, director of Seattle's Office for Civil Rights, which oversees the new rules, said the regulations are complicated because work life is complicated, and the City Council wanted the rules to reflect that. "There are just a huge number of ways in which people are employed," she said.

In Portland, activists want the rule to cover everyone, regardless of an employer's size.

"We don't have a lower minimum wage for small business," said Andrea Paluso, co-chairwoman of the Everyone Benefits coalition.

They think Portland, not the Legislature, is the best place to start. But they hope the policy expands to the state, then the rest of the country.

"There's a long history of Portland doing things ahead of the state," Paluso said. "This work trickles up."